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What is Viral Hepatitis?

Hepatitis is most often caused by one of several viruses, which is why it is often called viral hepatitis. In the United States, the most common types of viral hepatitis are Hepatitis B, and Hepatitis C. In the U.S., there have been significant decreases in Hepatitis A and Hepatitis B over the last several decades, largely due to vaccination programs.

Hepatitis B can range from a mild illness, lasting a few weeks, to a serious life-long or chronic condition.

Hepatitis C can range from a mild illness, lasting a few weeks, to a serious life-long infection. Most people who get the virus develop chronic Hepatitis C infection.

For reasons that are not known, 15%–25% of people “clear” or get rid of the virus without treatment.

How is it spread?

Hepatitis A is spread when a person ingests fecal matter—even in microscopic amounts—from contact with objects, food, or drinks contaminated by feces or stool from an infected person.

Travel to certain international counties is the biggest risk factor for Hepatitis A transmission. Contamination of food or water with Hepatitis A most often occurs in countries where Hepatitis A is common, especially if personal hygiene or sanitary conditions are poor. In the U.S., outbreaks of Hepatitis A still occur occasionally from contact with an infected person or eating contaminated food. Contamination of food can happen at any point: growing, harvesting, processing, handling, and even after cooking.

Hepatitis B is primarily spread when blood from a person infected with the Hepatitis B virus enters the body of someone who is not infected.

Most people with chronic Hepatitis B were infected with the virus at birth or during early childhood and developed a lifelong chronic infection.

The Hepatitis B virus can also be transmitted from:

Sex with an infected person

Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors

Sharing personal items such as toothbrushes or razors

Poor infection control which has resulted in some outbreaks in outpatient health care and residential care facilities

Hepatitis C is spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected.

This can happen through multiple ways including:

Contact with blood from an infected person (even in microscopic amounts)

Receiving a blood transfusion or organ transplant before 1992 (when the widespread screening of blood began)

Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes

Poor infection control which has resulted in outbreaks in some outpatient health care and residential care facilities

The risk for chronic infection varies according to the age when first infected. When infected as an infant, 90% will develop a chronic

75%-85% of people with Hepatitis C develop a chronic infection

5%-20% of people with chronic Hepatitis C develop cirrhosis

Treatment for Chronic infection

Not applicable

Regular monitoring for signs of liver disease progression; some patients are treated with antiviral drugs

Regular monitoring for signs of liver disease progression; some patients are treated with antiviral drugs

Who should be tested?

Testing for Hepatitis A is not routinely recommended.

Persons born in regions with moderate or high rates of Hepatitis B

U.S.–born persons not vaccinated as infants whose parents were born in regions with high rates of Hepatitis B

Household, needle-sharing, or sex contacts of anyone with Hepatitis B

Men who have sex with men

Injection drug users

Patients with abnormal liver tests

Hemodialysis patients

Persons needing immunosuppressive or cytotoxic therapy

HIV-infected persons

All pregnant women

Persons born during
1945-1965

Recipients of clotting factor concentrates before 1987

Recipients of blood transfusions or donated organs before July 1992

Persons who have injected drugs

Long-term hemodialysis patients

Persons with known exposures to Hepatitis C (e.g., healthcare workers after needlesticks, recipients of blood or organs from a donor who later tested positive for Hepatitis C)

HIV-infected persons

Patients with signs or symptoms of liver disease

Symptoms:

Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral Hepatitis can take decades to develop.